Título / Title

PROLIFERATIVE DIABETIC RETINOPATHY TREATED WITH INTRAVITREAL RANIBIZUMAB AND LASER PHOTOCOAGULATION TARGETED TO ISCHEMIC RETINA

Introdução / Purpose

To compare panretinal photocoagulation (PRP) as described in the Early Treatment Diabetic Retinopathy Study (ETDRS) combined with intravitreal injection of ranibizumab (IVR) (ETDRS-PRP group) and retinal photocoagulation targeted to ischemic retina combined with IVR (ISQ-RP) in patients with proliferative diabetic retinopathy (PDR)

Material e Método / Methods

Patients with PDR and no prior laser treatment were randomly assigned to receive either PRP plus IVR (“ETDRS-PRP” group) or retinal photocoagulation targeted to ischemic areas plus IVR (“ISQ-RP” group). PRP was administered in two sessions (at weeks 0 and 2) and IVR was administered at the end of the first laser session. Ophthalmic evaluation including ETDRS best-corrected visual acuity (BCVA), central subfield thickness (CSFT) measured by SD-OCT were performed at baseline and every 4 weeks through week 48. Area of fluorescein leakage from active new vessels (FLA) was measured by fluorescein angiography every 12 weeks until final visit. Additionally, full-field ERG was recorded at baseline and after 3 months follow-up

Resultados / Results

A total of 30 eyes from 22 patients were enrolled, but 22 completed the 48-week study period (12 eyes in the ETDRS-PRP group and 10 eyes in the ISQ-RP group). There was no significant difference between groups BCVA, CSFT or FLA at baseline (P > 0.05). Mean ± SE BCVA (logMAR) was 0.44 ± 0.07 and 0.37 ± 0.08; CSFT (µm) was 324.00 ± 20.44 and 330.07 ± 22.08 and FLA (mm2) was 16.1 ± 4.42 and 9.97 ± 1.83 for ETDRS-PRP and ISQ-RP groups, respectively. There was no relevant change on BCVA or CSFT during follow-up. A significant FLA reduction was observed at all follow-up visits compared to baseline for both groups, but there were no differences between groups. The mean number of IVR injections was 8 and 6.25 for the ETDRS-PRP and ISQ-RP groups, respectively

Discussão e Conclusões / Conclusion

Retinal photocoagulation targeted to ischemic retinal areas proved as effective as EDTRS-PRP, both associated with IVR injections, in reducing FLA up to one year of follow-up

Palavras Chave

diabetic retinopathy. ranibizumab, panretinal photocoagulation